Minimally invasive Chevron-Akin (MICA) osteotomies without Akin fixation in hallux valgus correction: a case series with 2-year follow-up

Purpose The minimally invasive Chevron-Akin (MICA) is considered the third generation of minimally invasive hallux valgus (HV) surgery, and its original description included fixation of the Akin osteotomy with a screw. The aim of this study is to evaluate a series of patients undergoing HV correction using the MICA technique without screw fixation of the Akin osteotomy. Methods We retrospectively evaluated 58 consecutive patients who underwent surgical correction for HV between August 2018 and March 2020. A total of 69 feet were evaluated with a minimum follow-up of 2 years. Clinical outcomes such as pain (VAS), function (AOFAS), range of movement, criteria personal satisfaction and complications were evaluated. Results The AOFAS score (mean +/- standard deviation) significantly improved from 57.0 +/- 8.6 preoperatively to 93.9 +/- 8.7 postoperatively (p < .001) with a minimum follow-up of 2 years. The VAS score improved from 6.0 +/- 1.8 preoperatively to 0.6 +/- 1.4 at 2-year follow-up (p < .001), and the hallux valgus angle reduced from 39.7 +/- 6.9 to 8.9 +/- 9.0 (p < .001). The majority of patients (95.6%) reported the result as excellent or good, and the most common complication was the need to remove the screw (7.2%). Conclusions The use of MICA without Akin osteotomy fixation resulted in successful correction of hallux valgus with improvements in clinical and radiographic parameters. Level of evidenceIV, case series.